S86 Turning the Tide: GLP-1 Agonists Improve Outcomes in Patients With Obesity Admitted With Acute Pancreatitis

Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are used in patients with obesity. The association between GLP-1RAs and the risk of acute pancreatitis (AP) remains unclear, and the outcomes among patients who develop AP while on GLP-1RAs have not been evaluated. Our aim was to evaluate 6 months’ outcomes of patients with obesity admitted with AP who were on GLP-1RAs vs those with no exposure to GLP-1RAs. Methods: We performed a retrospective cohort study using the TrinNetX database, a comprehensive multi-institutional dataset. The study included patients aged ≥18 years and BMI ≥30 kg/m2 diagnosed with acute pancreatitis from 1/1/2014 to 4/30/2025. Patients with any history of chronic pancreatitis were excluded. Patients were categorized based on whether they received GLP-1RAs (at least 1 month before the episode of acute pancreatitis) or did not undergo such treatment. The GLP-1RAs in our study were: semaglutide, liraglutide, dulaglutide, tirzepatide, exenatide, and lixisnatide. The primary aim was to assess outcomes of acute pancreatitis at 6 months. One to one propensity score matching was applied for age, gender, race, tobacco and alcohol use, comorbidities, and BMI. Results: Following propensity matching, a total of 7088 patients were included in the analysis for each group. Patients on GLP-1RAs had a lower risk of mortality, pancreatitis complications, ICU admission, respiratory failure, intubation, sepsis, acute kidney injury, shock, and portal vein thrombosis at 6 months as compared to patients with no exposure to GLP-1RAs. Conclusion: This large, multicenter, retrospective cohort study provides novel and compelling evidence that GLP-1RAs use is associated with improved 6-month outcomes in obese patients hospitalized with acute pancreatitis. Contrary to previous concerns that GLP-1RAs might increase the risk of pancreatitis, our results suggest a protective or benign influence on disease trajectory once pancreatitis has occurred.